Allergic vasculitis

A allergic vasculitis is a chronic inflammation of the blood vessels that lead to important organs. The causes of the disorder are unclear and there is no cure. The symptoms can be controlled with medication.

What is allergic vasculitis?

Allergic vasculitis is a disorder that causes blood vessels to become inflamed. The inflammation leads to bleeding in the smallest vessels (capillaries) in the skin, joints, intestines and kidneys.

In addition, the inflammation hinders the blood flow to the organs, which can permanently damage them. The most common symptom of allergic vasculitis is asthma, but the disorder can lead to a variety of other problems, including hay fever, rash, gastrointestinal bleeding, severe pain, and numbness in the hands and feet.

The large number of possible symptoms and the similarity of these symptoms to other disorders make allergic vasculitis difficult to diagnose. There is no cure for allergic vasculitis, but a doctor can help minimize symptoms by prescribing appropriate medication.

causes

A combination of factors is believed to cause allergic vasculitis, but these factors have not yet been identified. It is known that people with allergic vasculitis have hyperactive immune systems.

Instead of just protecting against invading organisms such as bacteria and viruses, the immune system also attacks its own healthy tissue, which leads to inflammation. Researchers are still trying to figure out what exactly is causing this reaction.

Some people develop allergic vasculitis after taking certain medications, such as asthma sprays and allergy medication. Experts have yet to establish the link between drugs and the onset of the disease. It is possible that the medication is simply increasing the symptoms of an existing illness.

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Symptoms, ailments & signs

Allergic vasculitis is initially expressed by general symptoms that also occur in various other diseases. For example, many patients suffer from fever, chills, and night sweats, or lose weight. Also typical is a strong feeling of illness that is associated with a physical and mental decline in performance.

One of the first symptoms is joint pain as a result of the inflammation. In the further course, depending on the severity and localization of the allergic vasculitis, further symptoms may arise. Spotty reddening of the skin or open, often bleeding areas of skin develop in the area of ​​the skin. If the eyes are affected, visual disturbances can occur due to the involvement of the vessels of the retina.

Redness of the eyes and inflammation of the dermis cannot be ruled out. If the nervous system is involved, this manifests itself, among other things, in headaches, inflammation and paralysis. If the course is severe, seizures or even a stroke can occur. The lungs can also become inflamed or the lungs can completely lose their function.

In the gastrointestinal tract, cramp-like abdominal pain, bloody diarrhea and colic are possible. In addition, allergic vasculitis can affect the heart, kidneys, muscles and joints as well as the ENT tract and cause a wide range of symptoms and complaints.

Diagnosis & course

There are no specific tests to diagnose allergic vasculitis. The symptoms are similar to those of other disorders. To make the diagnosis easier, however, there is a catalog of six criteria for allergic vasculitis.

A patient should meet at least four of the criteria in order to be diagnosed with the disorder. Criteria include: asthma, a high percentage of white blood cells, damage to one or more nerve groups, wandering spots or lesions on an X-ray, nasal sinus problems, white blood cells that are outside of the blood vessels. An additional blood test can find certain antibodies that are linked to the hyperactive immune system.

X-rays can help make the diagnosis if they reveal abnormalities in the lungs or sinuses. If tests already suggest allergic vasculitis, a biopsy of inflamed tissue may be performed.

Complications

Allergic vasculitis cannot be treated curatively. However, through appropriate medication, serious symptoms can be reduced to such an extent that the patient can live largely symptom-free despite allergic vasculitis.

As a rule, allergic vasculitis is treated with cortisone. Complications in treatment can therefore be seen in the severe side effects of cortisone. These include: Severe infections (bronchitis, pneumonia), bone loss and porous, fracture-prone bones, increased blood sugar. Depending on the severity of the allergic vasculitis, the doctor will start giving very high doses of cortisone and only reduce them in the course of the treatment.

Side effects are therefore usually to be feared at the beginning of a treatment and subside in the further course. Treatment with intravenous immunoglobulin is the gentlest of the treatments for allergic vasculitis. The immunoglobulin is given in a monthly dose; however, it is only indicated for mildly progressing allergic vasculitis.

If allergic vasculitis is not treated or treated incorrectly, the symptoms associated with vasculitis become life-threatening. These include: increased asthma with changes in the lung tissue and subsequent emphysema, bleeding on the skin and other organs through to damage to the heart, increased occurrence of white blood cells outside the bloodstream, damage to individual nerves and nerve groups.

When should you go to the doctor?

With this disease, a doctor should be consulted in any case. It will usually not heal on its own and there will be no spontaneous healing of allergic vasculitis. Medical treatment is necessary if so-called skin bleeding occurs. Should these occur, a doctor must be consulted immediately. Vasculitis can also show up as bloody urine or pain in the joints. A medical examination is required in any case with these complaints.

Without treatment, this can lead to nerve damage, which is usually irreversible. Usually the symptoms of allergic vasculitis are not characteristic and may point to another disease. However, the risk should be excluded by a visit to the doctor.

Furthermore, symptoms of the nose and sinuses can indicate this disease. In most cases, a general practitioner can be seen first. They can diagnose vasculitis with a blood test and then start treatment. In acute emergencies, the hospital can also be visited directly.

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Treatment & Therapy

There is no cure for allergic vasculitis, but proper medication can help people with serious symptoms improve their situation. The sooner treatment starts, the better the results will be. Medications that are used to treat allergic vasculitis include:

Cortisone is the most widely prescribed remedy for allergic vasculitis. High doses of cortisone may be given at the start of treatment to help control symptoms. However, since cortisone can cause serious side effects, including high blood sugar, bone loss, and severe infections, the doctor will slowly reduce the dose again to get the lowest dose needed.

Other Immune System Inhibitors: For people with minor symptoms, cortisone will be sufficient in most cases. Other drugs that inhibit the immune system can be used. But they are usually also associated with serious side effects.

Intravenous immunoglobulin: given as a monthly infusion, this treatment is the gentlest. However, it is also very complex and expensive and is not successful in all cases.

Outlook & forecast

As a result of vasculitis, patients primarily suffer from skin bleeding. These can significantly limit the everyday life of those affected and also significantly reduce the patient's quality of life. There is also severe pain in the joints and the urine continues to be bloody. In many cases, early diagnosis is not possible because the symptoms are not particularly characteristic.

If the vasculitis is not treated, the internal organs can also be damaged by the disease. The damage is irreversible and the affected person may then be dependent on a transplant. However, the vasculitis can be treated relatively well with the help of medication, so that the discomfort or pain can be limited. Life expectancy is also not restricted with early treatment. The internal organs in particular can be protected with proper treatment for vasculitis.

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prevention

There is no prevention of allergic vasculitis. The drug therapies can lead to a number of side effects that the patient can counteract. Taking cortisone will damage your bones in the long run. The intake of preparations that support bone building and targeted training help counteract the breakdown of bones. A healthy diet should ensure that the blood sugar level is kept down, and you should also urgently quit smoking.

Aftercare

Because the causes of allergic vasculitis are unknown, follow-up care is difficult. Nowadays it is at least possible to control the vascular inflammation with medication. Continuous monitoring of the patient is necessary because the allergic vasculitis leads to bleeding and pain.

Follow-up care for allergic vasculitis aims to improve the quality of life of those affected. An important prerequisite for this is that the symptoms are even recognized as allergic vasculitis. If this is not the case, internal organs are damaged unnoticed by the inflamed blood vessels. Such organ damage is irreversible. Therefore, once the diagnosis has been made, it is imperative that those affected are treated permanently and medically monitored.

The earlier the follow-up measures are initiated after the acute treatment, the higher the quality of life of those affected. The symptoms of allergic vasculitis can now be controlled to the extent that at least life expectancy does not suffer. However, the drugs administered can have side effects. It is therefore part of the aftercare to find other medication if necessary or to only do some things in the company of others.

The protection of the organs is an important concern in aftercare. The patient himself can help keep his blood sugar level stable through a healthier diet. Smoking and the consumption of luxury foods should be severely restricted.

You can do that yourself

To date, there is no cure for allergic vasculitis. Well-controlled medication and some precautionary measures can help people with severe symptoms improve their quality of life. In general, the disease should be clarified quickly, because the earlier treatment begins, the better the chances of recovery.

In addition to the drug therapy, which includes the regular intake of cortisone, sedatives and antibiotics, the patient has to change his lifestyle. Above all, a healthy diet is important. A suitable diet can regulate the blood sugar level and thereby reduce the risk of symptoms. Those affected also have to stop smoking and severely limit the consumption of other luxury foods. In addition, you should exercise regularly. Moderate exercise is recommended during treatment.

Since the prescribed medication can cause unforeseen side effects, the patient should be accompanied by a friend or relative at the beginning. Driving and other activities that require a high level of physical or mental performance should first be avoided. In case of doubt, the patient should take sick leave until the acute symptoms have subsided and the medication is optimally adjusted.